DESCRIPTION: (Applicant's Description) Considerable research has examined the short-term quality of life (QOL) effects of cancer diagnosis and treatments. However, comparatively less is known about QOL issues among long-term survivors (LTS), those who have survived five or more years after diagnosis. The available data on LTS conflict as to whether or not LTS continue to experience lasting chemical changes after cancer. A few psychosocial measures for use with LTS have recently become available, but they are general measures that do not assess the more subtle, fine-grained aspects of psychological well-being reported by many LTS that include cognitive, emotional, and spiritual adaptation after cancer. This application for a small grant proposes a two-phase study that addresses this gap in the literature. The overarching goal of the research is to examine adaptation to cancer from an adult developmental perspective. Phase I consists of in-depth qualitative face-to-face interviews with 56 adult LTS of several types of cancers from a range of age groups. The interviews will examine how cancer has affected LTS across the lifespan and will yield a more comprehensive picture of psychological well-being in LTS than has been previously available in the research literature. Interview data will be used to develop a measure of psychological well-being for use with LTS. Phase II consists of a mailed survey of over 1,500 adult LTS. Survey measures will include the newly-designed measure as well as existing measures of quality of life. Survey data will be used to describe psychological well-being in LTS across the adult lifespan and to conduct preliminary studies of reliability and validity of the new measure. The specific aims of this application are: (1) to identify unique aspects of psychological well-being associated with long-term survival after cancer; (2) to develop an assessment instrument that measures aspects of psychological well-being in LTS not evaluated by current measures of QOL; (3) to conduct preliminary examinations of reliability and validity of the new instrument and to examine the utility of existing instruments in a large sample of LTS; and (4) to explore the relative contributions of developmental stage, gender, tumor site, and other cancer-specific variables to psychological well-being in LTS.